Benefits of HRT justify a rethink, say
Reported 22 August, 2008
Women who take hormone replacement therapy (HRT) gain benefits in sleep and reduced joint pain.
A study looked at the benefits in older women of taking HRT, and concluded that they were significant.
The research, published by the British Medical Journal online, involved a trial that began in 1999 in Britain, Aus-tralia and New Zealand, and ended in 2002. The results covered a year of HRT treatment in more than 2,000 women aged between 50 and 69.
It concluded that the women given HRT showed significantly fewer hot flushes, night sweats, aching joints and muscles, insomnia and vaginal dryness than those given a placebo.
“This benefit must be weighed against the overall short and long-term risks, which must be individualised for women based on the years since menopause, medical history and chosen regimen,” the team reported. “Further research with appropriate measures is needed to assess more fully the impact of combined HRT on all aspects of health-related quality of life for postmenopausal women.”
The study, called the Women’s International Study of Long-Duration Oestrogen after the Menopause (Wisdom) was intended to last ten years but was stopped early because a study in the United States showed that older women taking HRT had an elevated risk of a heart attack. These results caused a panic, with about half the women on HRT giving it up. Proponents of HRT have claimed that the dangers were exaggerated.
The authors of the new study, led by Professor Alastair MacLennan, of the University of Adelaide, say that the benefits shown are such that “consideration should be given to revisiting HRT guidelines”.
Other experts urged caution yesterday. Professor Anne Kavanagh, director of the Key Centre for Women’s Health in Society at the University of Melbourne, said: “The increased risk of serious diseases including breast cancer, coronary heart disease and blood clots with the use of combined oestrogen and progesterone therapy is now well established.”
Professor Kavanagh said that the study did not show overall improvements in quality of life or depression. “In fact the study found that quality of life was lower in the women taking hormone therapy in the first few months of commencing treatment.”